Accountants for Care Homes and Nursing Homes
Written and reviewed by the Care Home Accountants editorial team. Last reviewed 28 July 2026.
We are Care Home Accountants, and we act for residential and nursing home owners across the UK. The work of a care home is not the work of a shop or a consultancy, so we do not treat it as though it were. Income arrives from several places at once, staff cost is the largest line by a wide margin, and the VAT rules run the opposite way to most trades.
This is the service to ask for when you want a firm to hold the whole picture: the statutory accounts, the funding reconciled to the beds, the tax return and the corporation tax, and the payroll that pays your carers. Preetesh Parmar FCCA at Tidy Money Ltd leads the work, and the point of contact does not change every quarter.
What We Handle for a Care Home
We prepare the annual accounts and the corporation tax return, run bookkeeping and management accounts across the year, and file the VAT where you are registered. We reconcile the fee income to the residents so that self-funder billing, local authority payments and NHS Continuing Healthcare money each land in the right place rather than in one undifferentiated lump. The detail of how those funding routes work sits in our guide to care home fees and funding.
We also carry the tax side: corporation tax at 19% on profits up to £50,000 and 25% over £250,000, the directors' remuneration and dividend planning, and the capital allowances on any building work. If you also run a home care arm, our domiciliary care accounting service covers that distinct model.
Where Care Home Numbers Get Awkward
Care that is welfare and delivered by a CQC-registered provider is exempt from VAT, not zero-rated. That means you charge no VAT on the fees, and you cannot reclaim the VAT you pay on refurbishment, agency staff or supplies, so it stays as a real cost. Exempt income does not count towards the £90,000 registration threshold either. We set that up correctly rather than let it surface as a surprise, and the reasoning is in our note on VAT and the welfare exemption.
The funding side is the other pinch point. A resident can move from self-funding to local authority support once their assessed capital crosses the means-test thresholds, and the numbers on your invoices have to follow that change. We build the reconciliation so the accounts always agree with who is actually paying for each bed.
How We Run Your Year
We work from cloud bookkeeping under Making Tax Digital, so the records stay current rather than being rebuilt each January. You send us the fee schedules and bank feeds, we keep the ledgers reconciled, and you get management accounts through the year instead of one late annual view.
At year end we prepare and file the statutory accounts and the corporation tax return, agree the payroll and pension position, and talk through the result before anything is submitted. Nothing goes to Companies House or HMRC without you seeing it first.
What Care Home Accounting Costs
We work to a fixed fee agreed before we start, based on the number of homes, the bed count and the funding mix, and the payroll headcount. You know the figure in advance, and it does not move because a month was busy.
Where the engagement covers several homes or a group structure, we scope each entity and give you a single combined quote rather than a set of unpredictable hourly bills.